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Clinicians face many challenges daily in attempting to develop and implement a treatment program for a pregnant woman suffering from opioid dependence. This article uses a specific case study that is illustrative of the type of situations encountered by clinicians who are treating opioid-dependent pregnant patients, in order to answer some common questions and discuss evidence-based approaches to meeting the clinical challenges faced when managing opioid-dependence during pregnancy.
It is estimated that each year, 53,400 babies are exposed to heroin or nonmedical opioid analgesics in the womb (NIDA, 1996). Since this survey was published, the nonmedical use of analgesics has increased for pregnant women, with self-reported use increasing from 51,900 in 1993, to an average of 109,000 in 2002 to 2004 (Colliver et al., 2006).